Abstract
IntroductionThe Amana Regional Hospital Laboratory in Tanzania was selected, along with 11 other regional and district laboratories, to participate in a pilot programme for laboratory quality improvement using the Strengthening Laboratory Management Toward Accreditation (SLMTA) training programme.Programme implementationThe SLMTA programme entailed hands-on learning, improvement projects between and after a three-workshop series, supervisory visits from an oversight team and an expert laboratory mentor to facilitate and coach the process. Audits were conducted at baseline, exit (approximately one year after baseline) and follow-up (seven months after exit) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. Quality stars (zero to five) were awarded based on audit scores.ResultsWith a dedicated staff and strong leadership from laboratory management, Amana Laboratory implemented processes, policies and procedures recommended as elements of best laboratory practices. The laboratory improved from zero stars (36%) at baseline to successfully achieving three stars (81%) at exit. This was the highest score achieved by the 12 laboratories in the programme (the median exit score amongst the other laboratories was 58%). Seven months after completion of the programme, the laboratory regressed to one star (62%).DiscussionAs the SLMTA improvement programme progressed, Amana Laboratory’s positive attitude and hard work prevailed. With the assistance of a mentor and the support of the facility’s management a strong foundation of good practices was established. Although not all improvements were maintained after the conclusion of the programme and the laboratory dropped to a one-star rating, the laboratory remained at a higher level than most laboratories in the programme.
Highlights
The Amana Regional Hospital Laboratory in Tanzania was selected, along with 11 other regional and district laboratories, to participate in a pilot programme for laboratory quality improvement using the Strengthening Laboratory Management Toward Accreditation (SLMTA) training programme.Programme implementation: The SLMTA programme entailed hands-on learning, improvement projects between and after a three-workshop series, supervisory visits from an oversight team and an expert laboratory mentor to facilitate and coach the process
When the Tanzanian Ministry of Health and Social Welfare (MOHSW) notified Amana Laboratory that it had been selected to participate in the SLMTA programme, the laboratory manager was aware of International Organization for Standardization (ISO) 15189, but he and his staff had no previous knowledge of SLMTA or the WHO AFRO accreditation preparation scheme
Amana Laboratory scored 36% at the baseline audit, well below the 55% needed for a one-star rating
Summary
Laboratories in Africa were largely ignored, distrusted and negated so that, for example, fewer than 50% of patients treated for malaria had laboratory confirmation of the disease.[1]. When the Tanzanian MOHSW notified Amana Laboratory that it had been selected to participate in the SLMTA programme, the laboratory manager was aware of International Organization for Standardization (ISO) 15189, but he and his staff had no previous knowledge of SLMTA or the WHO AFRO accreditation preparation scheme. The audits were conducted using the WHO AFRO Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on ISO 15189. The SLMTA programme consisted of three five-day workshops where participants (laboratory managers and quality officers of the selected facilities) were taught the skills they needed in order to improve the quality of their laboratory services. In February 2012, seven months later, an official WHO AFRO SLIPTA audit was conducted in Amana Laboratory by MOHSW on behalf of the African Society for Laboratory Medicine
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